The primary objective of the proposed research is to examine the extent to which persons with varying degrees of emotional and psychological problems use medical and mental health services differentially within an HMO. The population to be studied are Anglo and Hispanic attenders in a primary care section of an HMO in Los Angeles who were participants in a prior study which gathered data on psychiatric and psychological symptomatology (i.e., three psychiatric screening questionnaires - the GHQ-28, the HSCL-25 and the CES-D; the Diagnostic Interview Schedule), as well as patient and physician perceptions of the patients' medical and emotional health at the time of a primary care visit. The research proposes to add computer-based utilization data and chart abstract data to this extant data base. The available utilization data, which covers a 24 month period surrounding a primary care index visit, enumerates both ambulatory and inpatient health and mental health services use, ICD-9-CM diagnoses, RVS codes, laboratory and x-ray procedures, medication prescriptions, and associated costs of care. The major research questions to be addressed are: (1) is use of health services more strongly related to diagnosed mental disorder or to a more generalized form of psychological distress; (2) does the relationship between mental disorder, distress, and use of services vary significantly between Anglo and Hispanic samples; (3)what is the degree of concordance between patient reporting and physician recognition of emotional problems of the patient at the time of a primary care medical visit; and (4) what is the nature and extent of physician charting of patients' emotional problems in the medical record. The project will develop a multivariate model which best predicts the differential use of services on the basis of sociodemographic characteristics of the patient, scores on the psychiatric symptom scales, diagnosis on the DIS, perceived health and mental health status, perceived need for help with emotional problems, and physician perceptions of the patient's emotionsl condition.